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May 04, 2016 01:00 AM

CMS delays star ratings for HealthCare.gov plans

Virgil Dickson
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    The CMS has postponed its plans to roll out a star-rating system intended to help consumers make informed health coverage decisions when shopping on HealthCare.gov.

    In January, the CMS announced it planned to roll out a quality rating system for health plans on the federal marketplace this fall, in time for the individual market open-enrollment period for the 2017 plan year. The fourth open enrollment is set for Nov. 1, 2016 to Jan. 31, 2017.

    The agency now intends to introduce the ratings in time for the fifth open enrollment period, which kicks off Nov. 1, 2017.

    The star ratings will be based on access to care, how well doctors coordinate care with enrollees and other providers, whether a plan's in-network providers deliver care that achieves the best results, and on how enrollees rate their doctors and the care they receive.

    The CMS will use the extra year to conduct additional testing, the agency said in an April 29 notice. Part of that evaluation will involve a pilot launch this year in a handful of states, including Michigan, Ohio, Pennsylvania, Virginia and Wisconsin.

    State-based marketplaces may choose to post star ratings this fall, but the CMS encouraged them in the notice to wait for the new timeline.

    Health plans and providers have expressed support for the star-rating model.

    “Consumers will have information relating to the quality of the provider network offered by a (plan) that will not only benefit individual consumers, but will drive improvements in quality and service across the market,” Kaiser Permanente said in comment letter submitted to the CMS.

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          • - Luminaries
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          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
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      • Podcast - Beyond the Byline
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